The sella turcica is a saddle-shaped depression in the sphenoid bone at the base of the skull. Its name is Latin for “Turkish saddle,” a term derived from its appearance resembling horse saddles from that region. This bony structure’s shape and location are directly related to the important role it plays in the body.
Anatomical Location and Function
The sella turcica is positioned in the middle cranial fossa, a central compartment at the base of the skull. This placement ensures its contents are well-protected deep within the head.
The primary function of the sella turcica is to house and safeguard the pituitary gland, a pea-sized gland that rests within this bony enclosure, also known as the hypophyseal fossa. This gland is the body’s “master gland” because it produces and releases hormones that travel through the bloodstream. These hormones control bodily functions, including growth, metabolism, and reproductive processes, and also signal other glands to release their own hormones.
Associated Medical Conditions
Alterations to the sella turcica are linked to medical conditions, with Empty Sella Syndrome (ESS) being a noted finding. In this condition, the sella turcica is not empty but becomes partially or completely filled with cerebrospinal fluid (CSF). This fluid leak increases pressure within the sella, which can cause the pituitary gland to become flattened or shrink.
There are two classifications of this syndrome. Primary ESS occurs without an identifiable cause and is often discovered incidentally during brain imaging. Secondary ESS results from an underlying issue, such as a head injury, infection, radiation therapy, or surgery. Another condition affecting this area involves pituitary tumors, most of which are benign growths called pituitary adenomas that can enlarge the sella turcica.
Symptoms and Diagnosis
Pressure from an enlarged sella or from CSF in Empty Sella Syndrome can lead to chronic headaches. Because the sella turcica is located near the optic nerves, some individuals may experience vision problems, such as blurred vision or a loss of visual clarity.
Dysfunction of the pituitary gland can cause a wide range of hormonal imbalances. These can manifest as fatigue, irregular nipple discharge, or issues with reproductive function. Diagnosis may begin when these conditions are found by chance on imaging scans. An MRI is a reliable imaging method to view the sella turcica and pituitary gland, while CT scans may also be used. Blood tests are performed to measure the levels of various hormones it regulates.
Management of Sella Turcica Conditions
Management of sella turcica conditions is tailored to the specific cause and symptoms. Many individuals with asymptomatic Empty Sella Syndrome do not require active treatment but may be recommended for regular monitoring.
For patients who experience symptoms, treatment is directed at the root problem. If hormonal deficiencies are detected, hormone replacement therapy can be prescribed. In situations where a pituitary tumor is causing significant pressure or hormonal issues, surgical intervention to remove the tumor may be considered.